Dialogue Synthesis and Recommendations for Change April 30, 2015
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1 Dialogue Synthesis and Recommendations for Change April 30, 2015 On March 19, 2015, the Chicago Department of Public Health, Hope Street Group and Matter convened an expert group of 65 change agents and leaders specific to food insecurity and economic opportunity. This event was derived as a direct output of Hope Street Group s Annual Colloquium and a project with the Robert Wood Johnson Foundation, focused on how to effectively engage local stakeholders in working together to integrate effective, community-level initiatives and technologies a strategy that could offer transformative change on the issue, which is desperately needed in the city of Chicago. In collaboration with the Chicago Department of Public Health, and through the support of the healthcare incubator Matter, this event was structured to elevate the formative programs already in place and to address the issue of food insecurity by creating an innovative opportunity to generate impact. Attendees consisted of both local and national thought leaders, all committed to harnessing the collective voice and work of those directly impacting food insecurity. The intention was to recommend solutions for the Healthy Chicago 2.0 policy plan to roll out in June and to mobilize a public-private partnership to accelerate innovation and entrepreneurial activity throughout the city. A prime objective was to glean recommendations through galvanizing a sustainable group of health-related advisors to guide Chicago as a recognized city using collective impact to solve the rising health challenges that affect diverse components of social and economic mobility. In addition, the intention of the session to bring unique stakeholders who often work on the same problem, yet do not communicate together was further grounded and reinforced as a necessity for the city to have transformative change. Collaborative Recommendations for the Chicago Department of Public Health and Healthy Chicago 2.0 It was clear that addressing food insecurity must consist of a three-pronged approach across access, education/comprehension and affordability. There are multiple layers under each, which is why extensive and sustainable coordination is needed across the key players and, most importantly, as we identified, with the communities affected by the issue Notable outcomes from the discussion included the necessary components and the following recommendations that the group ask the government, private and philanthropic sectors to consider in making their decisions and investments on issues that relate to this topic. Specific to Healthy Chicago 2.0, these recommendations are intended to spur momentum and inform policy and community decisions. 1. Connect with the Community Meet the community where they are and utilize their channels Work must be grounded with the community, and not to the community Leverage current assets and community infrastructures Leverage the right tools and technology, e.g. mobile phones Engage thoughtfully with EACH community (and deliver on the commitments and pledges that many direct service entities (people and organizations) declare
2 2. Continuity: Construct a Sustainable Funding Model that is not Reliant on Philanthropy Alone Develop a sustainable funding pipeline Deploy long-term business interests and incentives models Institutionalize consistent and shared metric system across entities Make necessary foundational investments to build long-term goals 3. Tap into Economies of Scale Incentivize for more government and private partnerships Leverage technology and policy to build scale models Aggregate best practices and ideas for an economy of scale 4. Construct a Large-Scale Systems Approach Identify commonalities of food insecurity with other health-related issues and complexities Connect food insecurity to total health and healthcare 5. Collaboration across diverse entities Share resources and diminish competitive natures Disseminate findings, research and lessons learned (ideally through a user-friendly technology interface) Sustain and support ongoing dialogue and meetings to cut across silos through necessary financial support Leverage technology and analytics 6. Funding and Beyond Connect like-minded funders together, enabling an opportunity for shared resources and maximized investments Connect funders to organizations Connect organizations together Session Framing The session opened with facilitators Jay Bhatt, DO, former Managing Deputy Commissioner and Chief Innovation Officer at the Chicago Department of Public Health and Martin Scaglione, President and CEO of Hope Street Group, setting the context and precision problem framing. To set both the inspiration and expectation for problem solving and openness for the dialogue, keynote speakers included Seth Goldman, TeaEO of Honest Tea and Steve Collens, CEO of Matter. Both addressed the unique opportunity to stir the innovation pot and use creative and often nontraditional thought, partnership development and investment strategies to elevate the ideas and solutions that are working. All session participants were challenged to use examples and case studies similar to Honest Tea and top develop solutions to address food insecurity beyond traditional philanthropic measures. Following these keynotes, Daniel Block of the Chicago State University presented relevant and current data points, derived from the University and the Chicago Department of Public Health, on food deserts and the correlated data variables across socioeconomic status, race, grocery
3 store proximity, employment, housing and disease. It was clear from the trends and research that food insecurity is directly linked with numerous social variables and therefore must be addressed with solutions that go beyond food delivery and traditional soup kitchen models. The foundational levers of what causes food insecurity must be met by varying organizations and city government departments all committed to advancing an individual s opportunity. What was further articulated was the tremendous opportunity the city of Chicago has right at this moment: Since 2013, Chicago has committed to a citywide plan to address obesity-related health disparities, in order to identify priority communities and specifically focus their programmatic efforts on minimizing the risks associated with food insecurity. Common Ground To build consensus, the participants engaged in a full group discussion on current best practices in the field and the biggest hindrances to sustainably solving for food insecurity. It was largely recognized that many of the participants in the room were seeing progress with specific efforts on urban agriculture, retail restructuring and reinvestment models, the provision of better access to healthy foods and the recent city regulations and economic development resources. While these efforts were greatly applauded, the group recognized that significant barriers still anchor the root challenges of food security. Specifically, following a working group activity, participants noted the following as vital barrier levers; if these levers could be addressed, the numerous other barriers that often exist would be eradicated. These included: Unemployment Low-wage jobs Education and awareness Access to quality food Affordability The lack of corporations willing to change their profit model and culture for social good Sustained investments across philanthropy, government and corporations The healthy choice is often the difficult choice for vulnerable populations Simultaneously, the participants noted the significant opportunities that the field is currently experiencing. They further observed that, combined, these opportunities provide both a positive and altered playing field that allows for more innovations and unique stakeholders to get involved in the solution process. These include: Emerging technology Increased corporate responsibility and engagement Growing broad cultural movement increased industry trend on wellness Sense of collaboration via community programs Fundamental shift of food and nutrition science Successful good practices underway, with a clear ability and traction funnel for scale Shifted incentive structure for healthcare Untapped markets through social enterprise and innovations e.g. vertical farming Greater opportunity for government policies and incentives Tools and process for individuals to manage their health and health outcomes New programs and healthcare related programs that directly link food, hunger, etc. together
4 Community multi-stakeholder engagement To be successful, however, these solutions must be coupled with accurate consumer engagement and participation and relevant data and tool/support access along, with effective integration with the various government and policy paradigms in play. Dialogue Synthesis As the session continued, the participants broke into three groups to discuss the most vetted and identified components of food insecurity and barriers to shifting market response. These groups consisted of: 1. Education and Awareness 2. Affordability and Jobs 3. Access and Environment Each barrier component has core systemic challenges that need to be addressed with the appropriate experts and networks, as reflected in the meeting dialogue. 1. Education and Awareness For education efforts to be successful, they must be uniquely tailored to each community s needs. Oftentimes, education efforts are a one-size-fits-all approach, or involve a multitude of broken promises on behalf of a third-party solution. Time and time again, communities see heroes, but in the majority of cases, these heroes don t deliver, further disconnecting the community engagement that is vital to actual progress. While there has been active effort throughout schools and education programming, the content must be geared to provide nutritional information and understanding to be effective. Recommended best practices to expand reach to families and individuals include leveraging existing infrastructures and resources already active across communities, such as churches and libraries, and the growing campaign and demand for clean and healthy foods. Education efforts should be geared to empower individual choice, versus dictating what is wrong and what is right. 2. Affordability and Jobs This group quickly recognized while these two topics are usually mutually reinforcing, there is opportunity for reducing costs for healthy food through public-private partnerships that model effective scaling, market procurement and supply chain access. Government specifically has a large role to play in enhancing affordability measures. Often incentives are misaligned with achieving the greater good and maximized impact, leading to many organizations/people competing for resources instead of leveraging them together to create sustainable models of change. Further, the government could offer more incentives for food providers and vendors to decrease their costs of certain foods, either widely or through certain partnerships (for example, the vending machine options in Chicago Public Schools). The government also manages numerous food programs. This group articulated the opportunity to use more purchasing power to drive down costs with vendors or at least cause competition across vendors to provide more affordable options.
5 Government should enact policies that are both innovative and relevant to current demand, investing in opportunities such as urban agriculture, rather than providing unnecessary, largescale subsidies to practices such as cornstarch farming. Further, government could provide funding and incentives for a backbone organization to work with the various organizations in the space to identify the appropriate measurement system that could be instituted across all. This would significantly alter the impact that is currently occurring and provide a pathway to achieve measured results together. If policy can be responsive to current needs to incentivize collective impact and investment on the community side and increase pressure on providers/vendors to reduce costs to meet the new demand, we could see tremendous change in making healthy foods viable and accessible to more families and individuals. 3. Access and Environment This group noted the barriers that hinder widescale access to healthy food include relevant technology that is both user-friendly and specific to community needs, and improved understanding and comprehension of health choices and how it relates to overall healthcare. There was agreement that it is not about education specifically; while significant resources currently exist to bring awareness on the issue, the model often lacks a level of comprehension ability for multiple individuals to fully grasp. We are left asking how we can improve this understanding. Significant opportunity is directly connected in leveraging existing resources and building collaborative partnerships that will blend with an individual s current environment such as churches and schools. This type of collaboration and relationship building is vital to creating the necessary and sustainable funnels of change. Proven practices have been able to find and engage primary influencers across a community in order for a domino affect to transpire. A solution may rest in a one-stop-shop approach model where individuals are able to get resources, food, care and other needs in one nearby community center, versus having these needs fragmented and, oftentimes, widely spread across the city. In addition, effective use of government subsidies and programs could be altered to provide more choice for individuals. Data trends including age-based interest and behavioral studies reflecting that most people will invest in better choices if they are given the choice ahead of time to understand the problem on a more granular level. A portion of the discussion also included the need to share best practices and elevate what is working to improve access to healthy foods. There seems to be an overwhelming amount of resources and data, but it is not being articulated and conveyed to other change agents, leaving many to recreate the wheel. It would be a critical investment in the space to either build or elaborate a current model of this type of online depositary of information and resource guide so others can replicate and garner impact. Reflected in this working group discussion was also the timing and best entry point to engage the community. Again, this will vary per community and is very case sensitive. Next Steps for Action This diverse and expert group agreed that there must be an industry coalition set up and sustained that will operate on a shared measurement system and have regular opportunities to
6 communicate and share best practices. Determining this right dissemination channel is necessary, and the group challenged all three hosts to consider continuing work and investments to meet these demands. In addition, by creating and leveraging a dedicated group of change agents, this group will be able to actively continue building momentum, engaging other players, and spurring movement to accelerate the best and most innovative ideas. Hope Street Group and the Chicago Department of Public Health will be working to cultivate the investments and resources needed to make this core group and their vision a reality. In addition, the recommendations articulated will be shared widely with not only Healthy Chicago 2.0, but with the greater national network across health and healthcare. Additionally, the challenge of how to engage community stewards of change will be a topic at Hope Street Group s Annual Colloquium, where a detailed blueprint for change will be crafted and later deployed for multiple stakeholders to integrate and replicate in their practices. The dialogue and work done on March 19 will continue to be advanced through the coming months, and all of the partners look forward to the sustained engagement from those who attended.
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